Loss of balance function can lead to falls resulting in injury and even death. Epidemiological evidence has linked peripheral neuropathies to an increased risk of falling and one out of three elderly individuals age 65 and older falls at least once every year. This project will initiate commercialization of a wearable balance prosthetic device that can enhance balance and mobility. The device, termed "SmartSock", measures foot pressure in real time and conveys foot pressure information to the subject through a vibrotactile feedback array, placed around the lower leg. The device can either substitute lost foot pressure sensation;e.g. in individuals with peripheral neuropathy or it can act as a "balance booster" providing an augmentation of sensory information to individuals with general balance problems. The device can be worn in bed at night and turns on automatically when the wearer gets out of bed to go, e.g. to the bathroom. Using a first generation wearable prototype of the SmartSock we have acquired pilot data demonstrating that clinical parameters reflecting gait balance and mobility improve when elderly at-risk fallers use the device bringing them to non-faller status. Our current in-house hand-made version is not suitable for clinical trials and manufacturing. The current Phase 1 project will produce a next generation prototype of the device that will be tested for comfort and wearability in a small group of at-risk fallers. Our specific aims are to: 1. Design a new insole concept as two blanks ("small" and "large") that can be injection molded to incorporate air-pressure bladders, can be used to cut out intermediate sole sizes overall covering size feet between Mondopoint 225 to 295 (US women's size 5 to US men's size 12) and is integrated with pressure sensor electronics. 2. Select an optimal microcontroller and implement power-saving modes (standby/sleep) in the current software to better utilize features to extend battery life of the device. 3. Test the new device on elderly individuals (five men and five women) to ensure it provides relevant pressure feedback, is comfortable and is easy to don and doff. Achieving these aims will provide a robust new prototype of the SmartSock technology designed for use in a clinical setting. This would represent an important and critical step in the commercialization process of this technology, and enable clinical trials in a future Phase 2 proposal. PUBLIC HEALTH RELEVANCE: Loss of balance function can lead to falls resulting in injury and even death. This project will initiate commercialization of a wearable balance prosthetic device that can enhance balance and mobility. The device, termed "SmartSock", measures foot pressure in real time and conveys foot pressure information to the subject through a vibrotactile feedback array, placed around the lower leg. The device can either substitute lost foot pressure sensation, e.g. in individuals with peripheral neuropathy, or it can act as a "balance booster" providing an augmentation of sensory information to individuals with general balance problems.